CMS Releases Proposed Provider Anti-Fraud Rule from AHA

Sep 22, 2010 10:53 AM
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CMS releases proposed provider anti-fraud rule 


From the AHA - The Centers for Medicare & Medicaid Services yesterday issued a proposed rule intended to strengthen Medicare and Medicaid fraud oversight by, among other provisions, bolstering provider and supplier screening procedures, suspending payments and requiring state Medicaid programs to stop using providers that have been excluded from Medicare or another state's Medicaid or Children's Health Insurance Program. The proposed rule carries out provisions of the Patient Protection and Affordable Care Act. Simultaneously, CMS is preparing to issue a proposed rule regarding hospital compliance programs, as required by the ACA. The agency is seeking input from hospitals and others about what should be required in compliance plans, as well as information about their current anti-fraud compliance programs, including how they have incorporated U.S. Sentencing Guidelines, their programs' costs, benefits and effectiveness of such programs, and the systems necessary to implement them. Comments are due to CMS by Nov. 16. CMS plans to issue the proposed rule on compliance program requirements at a future date.




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